Trazodone Side Effects: Long Term And Rare Adverse Reactions

Last Updated: November 1, 2021

Authored by Nena Messina, Ph.D.

Reviewed by Michael Espelin APRN

Trazodone is an antidepressant that has been in use since the early 1980s. It is an FDA approved drug for not only depression but is also prescribed by medical professionals for the treatment of health conditions like insomnia along with Trazodone anxiety and panic attacks. Like all other antidepressants and the drugs which act exclusively on the central nervous system, it has some undesired reactions. Knowledge and information about Trazodone 50mg side effects are important for prompt handling of symptoms. Awareness of Trazodone side effects can help patients in understanding what to expect when they are on medicines. Not only that, but it also helps them figure out when they should seek medical assistance or consider going for Desyrel drug detoxification. Take a look at what the common, rare, and long-term Trazodone side effects are and how to manage them.

What Are The Side Effects Of Trazodone

Trazodone is used to treat depression and other mental health conditions such as panic attacks, anxiety, insomnia, and schizophrenia. It works by altering neurotransmitter levels in the brain. These neurotransmitters include serotonin, dopamine, and noradrenaline. Trazodone 50 mg side effects are mainly due to an altered level of serotonin and dopamine in the system. Like with any drug, there are many mild and severe Trazodone side effects.

Common Trazodone 50 mg Side Effects Include:

  • Headache
  • Dizziness
  • Drowsiness
  • Blurred vision
  • Nausea, vomiting, stomachache, loss of appetite, diarrhea, constipation
  • Weight gain or Weight loss
  • Fatigue
  • Confusion, disorientation, or nervousness
  • Tinnitus or ringing in the ears
  • Anticholinergic adverse reactions including dry mouth and dry eyes
  • Rash
  • Sweating
  • Dry mouth

In addition to the mentioned side effects, the drug acts on different body systems. To convey a better idea, here are side effects classified according to the systems they affect, and their incidence.

A woman experiencing Trazodone side effects is lying in bed and looking at pills.

Gastrointestinal System

Dry mouth is the most frequent Trazodone effect on the gastrointestinal tract. Other common unwanted symptoms include abdominal pain, diarrhea, nausea, vomiting, constipation, and gastric distress. The point to note is that they are mild and will go away on their own once the body adjusts to having a certain dosage of the drug in the system.

The Cardiovascular System

It can cause hypertension due to noradrenaline and serotonin uptake inhibitory effect. Along with hypertension, its other common effects are edema and bradycardia. In some cases, depending on the metabolism of the patient, it can also cause hypotension instead of more common hypertension.

Respiratory System

The most common respiratory adverse reaction is nasal and sinus congestion. It can be particularly uncomfortable for the patient and can mimic the symptoms of rhinitis. Other unwanted symptoms include shortness of breath and difficulty breathing. One should consult a medical professional about its dosage if they have any underlying respiratory conditions like asthma, Emphysema, or allergies.

Nervous System

Drowsiness, dizziness, and lightheadedness are the most commonly encountered symptoms. They can all be attributed to the serotonin levels in the body. Some other common reactions that patients may experience are rebound Trazodone anxiety syncope, tremors, confusion, and decreased concentration.

The aforementioned list covers only the common side effects of Trazodone. These symptoms are usually temporary due to altered neurotransmitter levels and resolve on their own. As always, there can be some other uncommon and rare adverse reactions that are not mentioned above. The drug metabolism can vary with the patient and their medical conditions. Some may experience severe side effects which need immediate medical consultation. That’s why it is important to seek help if one experiences any adverse reactions.

Long Term Effects Of Trazodone

It is an FDA-approved medicine for the treatment of depression, Trazodone anxiety, and insomnia. It is a safe prescription medication when used for its intended purposes. With its long-term use, there is an increased risk of more severe and rare side effects. Long-term prescription carries its own risks and doctors only prescribe it when the benefits of the medicine use outweigh the complications caused by its long-term use. If one is abusing the drug or taking more than the recommended dose, a person is at a higher risk of experiencing these side effects. It is important to seek help in case of drug abuse for a long time.

Dangers Of Trazodone Long Term Use

Long-term Trazodone use has many potential nervous system side effects along with ocular and cardiac problems. These adverse reactions are not common with short-term use. They only manifest with months of drug use, overdose, or acute drug abuse.

Some of These Long-Term Effects of Trazodone Are Listed Below. They Include:

  • Headaches
  • Concentration Difficulty
  • Memory problems
  • Confusion
  • Agitations.
  • Fainting
  • Incoordination
  • Tremors
  • Blurred vision
  • Glaucoma
  • ECG abnormalities

In rare cases, it can also cause serotonin syndrome with its long-term use. Other rare long-term effects include altered memories, verbal learning difficulty, increased risk of manic or depressive episodes, equilibrium disruption and increased falling frequency, next-day sedation, performance problems, and changes in weight. The doctor may decrease the drug dose or change it with some other medication if one is experiencing these effects.

Rare Side Effects Of Trazodone

There are some effects which only affect less than 1% of users. Although these may not be common they are worth mentioning. Some of these can be severe and need medical assistance while others are mildly inconvenient. Information about these symptoms can help in the management of Trazodone Side Effects.

Some Of The Less Common Short- And Long Term Effects Include:

  • Tremor
  • Vertigo
  • Increased appetite
  • Poor coordination
  • Hair loss
  • Acne
  • Anemia
  • Double vision
  • Urinary retention
  • Dreams (vivid or bizarre dreams)

These side effects are extremely rare and can get misdiagnosed. Make sure if the patient is not on the drug for any medical condition if they present with any of these symptoms. Although these can become uncomfortable and affect functionality in some patients, doctors may still opt for drugs if the benefits of the drugs outweigh these potential risks.

Trazodone Warnings And Contraindications

Besides its long-term side effects, there are other Trazodone warnings, like intolerance and allergic reactions to the medication that can occur. It is not suitable for the treatment of depression in young adults due to increased suicidal tendencies. Its use with MOAI is also contraindicated due to the increased risk of serotonin syndrome.

Here Are Some Common Contraindications To The Drug:

  • Co-administered with other CNS depressants– increased risk of serotonin syndrome.
  • Hepatic dysfunction– it is metabolized in the liver.
  • Cardiac patients– it can cause acute myocardial infarction.
  • Renal failure– metabolites are excreted in urine and can accumulate in blood if renal function is impaired and deteriorates health.
  • Increased intraocular pressure– It can worsen closed-angle glaucoma
  • Hyponatremia–  it can cause electrolyte imbalance and worsen hyponatremia.
  • Bipolar disorder– it can aggravate manic or hypomanic episodes

The FDA has issued a black box Trazodone warning because this medicine can lead to an increased risk of becoming suicidal. This risk is highest when treatment is first started or when the dose is adjusted. The risk is also higher in young adults under the age of 24. In some people, the drug leads to an initial worsening of depression before it kicks in and improves depression symptoms. Because of the black box Trazodone warning, it is essential to watch out for symptoms such as irritability, aggression, restlessness, worrying, and suicidal thoughts when someone is taking serotonin modulators. All patients should be monitored for change in behavior or any suicidal thoughts or tendencies specifically at the initiation of dosage and with the dose changes.

A man pours Tazodone pills in his hand.

Trazodone And Sexual Drive

Antidepressants are known to decrease sexual desire but Trazodone has the opposite effect. Studies have evidence that it can increase sexual drive in both men and women. It is associated with prolonged erection in men and increased lubrication in women although its mechanism of increasing libido is still unknown, it is thought to be a side effect of serotonin reuptake inhibition. Its use for the treatment of disorders involving sexual desires is still under debate.

Trazodone Female Side Effects

Trazodone female side effects are not all bad. Some of them have the potential to become empirical therapy for sexual disorders. It improves all four dimensions of sexual functions in women. Which include desire, erection or lubrication, ejaculation, or orgasm in women. It may also be used for the treatment of SSRIs induced sexual dysfunction or loss of libido in women.

Trazodone Male Side Effects

In males, it can cause a long-lasting erection which over time can injure tissue. It can lead to erectile dysfunction with overdose and abuse. It can also cause priapism in males, which means prolonged erection or erection in response to even minor stimuli. Furthermore, it increases all the four dimensions of sexual drive in men. These include desire, erection, orgasm, and overall sexual satisfaction. While the use of drugs as empirical therapy for erectile dysfunction is being studied, prolonged use has the potential risk of tissue damage.

What Causes Trazodone Side Effect Emergence

Many factors influence the emergence of side effects in individuals. These include age, medical conditions, idiosyncrasy, dose, and duration of medicine. One of the most critical factors that have an impact on the emergence of side effects is age. As noted by the black box warning, young adults are susceptible to suicidal tendencies. Elderly patients may be more sensitive to Trazodone side effects.

Idiosyncrasy is another crucial factor. It can cause drug interaction with alcohol, anticoagulants, and other SSRI drugs. The use of other medications along with Desyrel or Oleptro may affect how they work. Some of the drugs with Trazodone interactions include blood thinners such as Coumadin, SSRI antidepressants such as Prozac, water pills, and cold and allergy medications. Therefore, it is important not to mix the drug with alcohol as this may make these symptoms more severe.

Reducing Or Preventing Unwanted Adverse Reactions

The first and foremost step towards reducing adverse reactions is taking the recommended dose in the recommended time and avoiding any co-administered drugs to prevent drug interaction. The doctor may also increase the dose gradually to decrease the frequency of side effects. Consultation and getting information about certain side effects and how long Trazodone stays in the system can help one in their management. Most of the common side effects are temporary. They resolve on their own and cause mild inconvenience. Other health conditions such as blurred vision, glaucoma, suicide ideation, cardiac abnormalities, and serotonin syndrome are more severe and need medical assistance. Consult the doctor if the patient experiences any of these symptoms.

A lower dose may be prescribed to reduce or prevent the symptoms. However, Trazodone withdrawal may occur if the medication is stopped suddenly, with symptoms such as dizziness, agitation, and irritability, so this should only be done under medical advice.

Drug addiction, although not a side effect in the general understanding of this term, may also harm. Its abuse can be treated by medical professionals. Reach out for help and get a referral to the addiction rehab facility nearby.

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Published on: April 1st, 2019

Updated on: November 1st, 2021

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.